Top 7 Tips for Billing Insurance

For many massage therapists, the thought of billing insurance providers for services rendered may lead to unnecessary stress and uncertainty as to where to begin. Insurance and state laws vary depending on location, which can lead to even more confusion for massage therapists looking to expand their client base by accepting medically prescribed clients.

Here, Vivian Madison-Mahoney, L.M.T., discusses some of the more general issues surrounding the topic, such as how reimbursements work, if they work and where to find more information. Mahoney believes that “[Accepting medically prescribed cases] should be fun and rewarding despite the extra work and challenges that it sometimes incurs.”

1. DECIDE IF BILLING INSURANCE IS WORTH THE EFFORT

Madison-Mahoney says that whether or not learning injury, Med-Pay and uninsured motorist coverage, according to Madison-Mahoney. However, if you want to bill insurance, she adds. “It ultimately all depends on which state you reside in, as the laws are different for each state.”

2. MAKE SURE A PRESCRIPTION HAS BEEN WRITTEN

Another tip regarding a practice where you bill insurance is: “I think it is important to remember that insurance companies reimburse for medically necessary treatment,” Madison-Mahoney says. Because massage therapists cannot render a diagnosis, a client must come from a treating physician with a written prescription, she adds. “Without the prescription to go along with the receipt, an insurer could reasonably deny the client’s reimbursement.”

3. BECOME EDUCATED ON YOUR STATE LAWS

According to Madison-Mahoney, while most insurers cover massage, most health insurance companies do not often reimburse massage therapists directly. “However,” she says, “every time you uncover one that does, that is one more client that you are helping and one more deposit in your bank.”

For now, the types of insurance that will reimburse a massage therapist are what are called liability-type cases. These cases are defined as would-be auto insurance, personal injury protection, bodily injury, Med-Pay and uninsured motorist coverage, according to Madison-Mahoney. However, she adds. “It ultimately all depends on which state you reside in, as the laws are different for each state.”

4. CONFIRM THAT YOUR SERVICES ARE COVERED

“Never bill an insurance company for a client’s services without knowing 100 percent that it is billable by, and payable to, a licensed massage therapist,” Madison-Mahoney says.

She suggests that if your client is unsure whether or not your services are covered under her policy, the client should bring in a copy for you to go over yourself. “Look for what is covered, what is not covered, who is a covered provider and under what conditions,” Madison-Mahoney adds.

5. STAY AWAY FROM MEDICARE AND MEDICAID

Medicare and Medicaid are not something you may bill insurance for, as they do not cover the services of a massage therapist, Madison-Mahoney says. “Many have tried and have later been asked for a return of reimbursements,” she adds. The only way you can be paid for your work on a Medicare client is by cash. If this is done in a physician’s office, the physician would have to be sure the Medicare patient signed an Advance Beneficiary Notice form. “This form indicates to the client that the services would not be covered under her Medicare Plan.”

6. TRUST YOURSELF FIRST

“Often a client will not know how to read his policy,” Madison-Mahoney says. “It is possible that he could misunderstand it, misinterpreted what someone was telling him about it when he signed up, or have the same the insurance company, with a different plan, as a friend who has a policy that covers massage therapy provided by a massage therapist. Just don’t take his word for it that his policy covers your services.”

7. RECEIVE PROPER TRAINING

Madison-Mahoney believes that education is key when it comes to your plan to bill insurance, and that “it is crucial to receive proper training from someone who has the knowledge and experience to teach it.”

She says, “I always tell therapists that medical cases are also legal cases; therefore, she must gain proper knowledge of the industry. Learning about documentation forms that will pass the scrutiny of insurers is part of operating expenses and is tax deductible.

“Having the correct tools at your disposal helps to alleviate a tremendous amount of stress, and this enables therapists to greet their clients with a relaxation and joy.”

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